Provider Demographics
NPI:1790486272
Name:THE LIFELINE CENTER, LLC
Entity Type:Organization
Organization Name:THE LIFELINE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNSON-MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC-S
Authorized Official - Phone:843-731-9100
Mailing Address - Street 1:PO BOX 4167
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-4167
Mailing Address - Country:US
Mailing Address - Phone:843-731-9100
Mailing Address - Fax:843-879-0613
Practice Address - Street 1:2126 W JODY RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-2032
Practice Address - Country:US
Practice Address - Phone:843-731-9100
Practice Address - Fax:843-879-0613
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE LIFELINE CENTER, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty